Healthcare Provider Details
I. General information
NPI: 1639664782
Provider Name (Legal Business Name): LIMAR ADULT DAY HEALTH CARE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/29/2018
Last Update Date: 06/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2809 TWEEDY BLVD UNIT B
SOUTH GATE CA
90280-5538
US
IV. Provider business mailing address
2809 TWEEDY BLVD UNIT B
SOUTH GATE CA
90280-5538
US
V. Phone/Fax
- Phone: 323-567-9919
- Fax: 323-567-9929
- Phone: 323-567-9919
- Fax: 323-567-9929
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
LIOR
BARKODAR
Title or Position: OWNER
Credential:
Phone: 323-810-5090